Cardiovascular Benefits of <i>Salvia miltiorrhiza</i> (Danshen) Supplementation: Bioactive Constituents, Mechanisms, Clinical Evidence and Implications for Nutritional Care

(Danshen), a traditional Chinese medicinal herb rich in tanshinones and salvianolic acids, has been investigated for multi-target cardiovascular effects. This narrative review summarizes key phytochemical classes, preclinical mechanisms, human clinical findings, and formulation approaches aimed at improving bioavailability. Preclinical studies consistently report antioxidative, anti-inflammatory, vasodilatory, antithrombotic, and anti-fibrotic activities, involving pathways such as endothelial nitric oxide signaling and modulation of NF-κB/MAPK-related inflammation. Clinical studies have reported potential benefits in conditions such as coronary artery disease and myocardial ischemia; however, the overall evidence is limited by heterogeneity in preparations and dosing, variable product composition, small sample sizes, and a shortage of rigorously designed trials. Practical translation is further constrained by poor solubility and rapid metabolism of key constituents, though delivery platforms (e.g., liposomes, nanoparticles, and self-microemulsifying systems) may enhance exposure in experimental settings. Overall, Danshen remains a plausible adjunct candidate, but standardization and high-quality randomized clinical trials are needed to establish efficacy, safety, and interaction risk with conventional cardiovascular therapies.